Sanjo Parte has cooked bottle gourd curry and rice for lunch today. 27-year-old Sanjo hands a bowl of rice-curry to her daughter as she covers her son with a mosquito net. He is a few months old and Sanjo uses the net to protect him from flies and mosquitoes, who are in abundance in her house and around. “This is how it is during the monsoon. It’s muddy all around and the flies just won’t leave us alone,” Parte says. “I had cooked masoor dal (lentil) yesterday,” she adds.
We sat in Sanjo’s mud house in Dhamanpani village of block Mohgaon in Mandala district in Madhya Pradesh, which is being restored because one of its walls fell due to a heavy storm, few days back.
Madhya Pradesh has a significant tribal population, which constitutes more than one-fourth of its total population and 14.7 percent of India’s total tribal population. Out of the total population of MP, about 72.4% live in rural areas. According to the Tendulkar Committee Report 2009, nearly 48.6% of the population is estimated as living Below Poverty Line (BPL) with rural poverty ratio.
According to census 2011, In rural MP, 30% children weighed less than 2.5kgs at birth, while in Mandala the figure hikes to around 35%.
Lucknow based gynaecologist, Dr Neelam Singh says, “the quality and quantity of food intake of pregnant women affects her own health during and after delivery as well as her children’s. Less intake of nutrients could lead to anaemia, which in worst conditions could even lead to mortality.”
Parte further adds that, “See, I had learnt in the Poshan Karyakram (nutrition program) that we must eat well. And we can’t afford to buy vegetables, we shall opt for growing it ourselves, so have I done.” She says and mentions the vegetables she had in her kitchen garden- cucumbers, potatoes, bitter guard, tomatoes etc. “It is not feasible for us to buy vegetables and go to the market, regularly, in the first place. But the idea of setting up our own backyards as Poshan Vatika (kitchen garden) saved us. Though, it was a challenge to convince men of our house, initially because they have been using the land for traditional cropping only but once we began growing vegetables they were impressed to, Sanjo further adds.
Sanjo shares how most of the young mothers in her village are anaemic and underweight and kitchen garden has been a boon to all such women. “Apart from improving our diet by adding colours in our plate, we have started to question old, traditional ways of delivery and post-natal care because premature delivery was another common problem among the women of our villages,” she says.
In Dhamanpani, where Sanjo lives, 40 anaemic women started kitchen gardening and some have even recovered from anaemia.
Experts blame imbalance in dietary pattern – due to poverty (in rural) and consumption of junk food (in urbans) for anaemia.
Anemia is the condition of having a lower-than-normal number of red blood cells or quantity of hemoglobin. It can make one feel tired, cold, dizzy, irritable and short of breath, among other symptoms.
The COVID19 crisis in the country resulted in an increase in micronutrient malnutrition, including anemia due to the disruption of health services and food systems on top of an economic crisis.
Soon after the announcement of first national lockdown, Madhya Pradesh Chief Minister Shivraj Singh Chouhan had announced that all Below Poverty Line (BPL) families would be provided a month’s ration free.
Similarly, Kamlawati’s life has changed post PRADAN’s trainings with the support of IKEA Foundation. Being a new mother, Kamlawati now eats regularly, rests well and even opted for institutional delivery. She even cooks in the iron pan to increase the iron intake in her body.
Kamalwati lays in a charpoy, breastfeeding her infant as we speak to her. The charpoy is placed behind the door to restrict sunlight and direct visibility from the passer-by. She has not moved out of her two-room house, post-delivery. She is supposed not to for at least a week more, now.
34-year-old Kamalwati Tumrachi, who lives in Machhla village of Mohgaon block in district Mandala, has given birth for the third time. But what’s different this time is her awareness about the postnatal care. “Amma, babu would say that I need to feed the baby in the fourth or fifth month itself. That’s what everyone in the village does. They’d even make the baby lick honey in the first few months and I was fine with all of this unless I was told how this could affect the infant,” Tumrachi says, as she covers her head with a woollen scarf. Her daughter and attending classes with her neighbour, on the only smartphone the family has.
Tumrachi further tells, “In our village, children are bathed right after the birth, as a part of tradition. This is regardless of the season and weather. But I resisted it. My Haemoglobin was 7 and weighed 30, before delivery, during the first trimester of pregnancy, both of this below average. But now I am in a better condition with around 11 g/dl,” she concludes.
“As a part of our Poshan Abhiyan, Perspective Building has been categorized in preparation of delivery and family planning among the women. The mothers-to-be were made aware about the importance of consuming nutritious food and ways to combat diseases.
Women were also encouraged to know their rights,” says Dikhyani from PRADAN who has been observing Kamalwati’s health and lifestyle closely, apart from hundreds of others in the block, under the STaRtuP project supported by IKEA Foundation. PRADAN is a non-profit organisation, working with women of several villages to ensure the overall wellbeing of their family by improving nutrition and agriculture of the women.
Kamlawati shares that 3-time meals in a day haD been a dream for her till very recently. It is the case for most of the women. “I even know many families in my neighbourhood where women skip one meal due to insufficient quantity of food. Mostly men of the house would consume Pej (Maize soup/ juice) as breakfast while women would be busy cooking their first meal- lunch,” she tells. Pej is considered to be the best source of energy by local people. Pej is also taken during diarrhoea.
Pandemic and nutrition
Covid-19 further tested India’s food production and supply systems, which were already stressed due to the climate crises.
“As breadwinners lose jobs, fall ill or die, the food security and nutrition of millions of women and men are under threat, with those in low-income countries, particularly the most marginalized populations, which include small-scale farmers and indigenous peoples, being hardest hit,” read a WHO report published in October 22.
Kamalwati was underweight during her pregnancy. “I weighed 30kg during the first trimester of pregnancy,” she said. “That’s when I began regular check-ups with the auxiliary nursing midwife (ANM).”
She began growing green vegetables and fruits in her backyard, the only way she could boost her nutrition, as the cost of vegetables skyrocketed. Besides, rice along with dal twice a day (morning and night) is her constant meal. Here, pulses are grown in abundance. Only shortage is intake of vitamins, iron and other minerals which have its sources in fruits and vegetables. Carbohydrate and protein intake is common in the majority of households. Pej, which is taken during the day, is also a source of carbohydrate.
Under the STaRtuP project (Self-help group led Transformation of Rural communities through Partnerships) supported by IKEA Foundation, messaging of basic concepts and technical information around different aspects of health and nutrition was done through two modules: Perspective Building 1 and Perspective Building 2 which contained a total of 9 sessions. The major forms used in the modules for dissemination were about early marriage and how it relates to deteriorating health among women. It focused on how tricolour food can be consumed at low cost through kitchen gardens and how it can enhance the practice of better food intake practice of women along with other family members.
The STaRtuP project adopts a cascade approach where Mentors (trained cadre and paid from project) support the change vectors (non-paid volunteers) in the transaction of the pictorial, story-based micro modules with SHG members. Women were trained around health & nutrition, dietary diversity (tri- colour food), nutri-sensitive agriculture, introduction of strategic actions like: use of iron vessels to cook; kitchen garden etc.
These training programs were designed by Pradan’s technical partner, Public Health Resource Society (https://phrsindia.org/). “PHRS not only trained people and made mentors in the villages but also conducted training for PRADAN staff and mentors. Then, with the help of change vectors and mentors, we approached the other residents in our villages and ensured that the learnings were in practice,” added Dikhyani.
In 1000 sq ft of land, she planted tomatoes, brinjal, bananas and a mixture of leafy climbers.
Kamalwati’s husband, Mayaram Tumrachi, a mason in the southern state of Andhra Pradesh was one among millions of migrant workers who had to find their way home on foot or on other unreliable transport in 2020 when Prime Minister Narendra Modi announced a nationwide lockdown without sufficient notice.
Back in the village, Kamalwati stayed with her parents, and her pre-teen daughters managed her fields, dreaming of having three meals a day.
“I know many women in my neighbourhood who skip one meal due to insufficient quantity of food,” she said. “Most men of the house would consume Pej (maize soup/ juice) as breakfast, while women would be busy cooking their first meal- lunch.”
In October 2016, the project’s piloting was done in 30 villages with 281 SHGs (around 3000 HHs) in Mohgaon block which was the only block for piloting in Mandla. Later in 2019, it was extended to the rest of the villages in the block.
Jigyasa Mishra is an independent journalist from Chitrakoot, UP. Jigyasa writes, captures & illustrates rural issues.